Joint instability Flashcards
Hip luxation is often associated with?
Trauma
How is hip luxation diagnosed?
Can be diagnosed on clinical examination when obvious
If not radiography is the imaging modality of choice
What are the two main directions of hip luxation?
- Craniodorsal (most common)
- Trauma
- Dysplasia - Caudoventral
- Abduction of limb (splayed leg)
If a pateint has hip luxation, you should also assess it for which condition, why?
Hip dysplasia
If it does – surgery needed
What are the clinical signs of craniodorsal hip luxation
Internal rotation of the limb
Non weight bearing (often)
Greater trochanter higher than normal
List the 3 palpable landmarks of the hip
3 palpable landmarks – should make a triangle in the normal animal. If there is luxation they can become a straight line
- Ileal wing
- Ischiatic tuberosity
- Greater trochanter
What are the clinical signs of caudoventral hip luxation
Not easy clinically
Greater trochanter lower
Pain ++ (esp CF craniodorsal)
Triangle maybe larger cf contralateral side
Why is it important to know the direction of hip luxation?
Clinical identification is different
Way to reduce is different
Post reduction stabilising techniques
Describe the non-surgical reduction technique for craniodorsal hip luxations
- Needs to be done in first few days
- GA ideal or sedation plus epidural
- Dog in lateral recumbency (affected limb uppermost)
- Towel/ rope around inguinal area (assistant needed)
- Externally rotate the limb to release the femoral head
- Traction caudodistally
- When femoral head distal to dorsal acetabular rim, internally rotate limb
- Immediately radiograph to confirm reduction
When are mandibular physeal separations most commonly seen?
In cats after a fall
How are mandibular physeal separations diagnosed?
Clinical exam:
- Mandibular canines misaligned
- Excess movement
Radiographs:
- Not essential for physeal separation itself
- Needed for other possible fractures
- CT better – day one!!!
How are mandibular physeal separations treated?
Muzzle - Best stabilisation
Wire - Metal, PDS
What are the causes of carpal hyperextension?
- High rise fall (off a wall for example)
- Degeneration (esp. border collies)
- ‘Collateral ligament’ injuries
- Inflammatory arthritis (IMPA)
How is carpal hyperextension diagnosed?
- Clinical exam (compare with other limb but be careful of bilateral injuries)
- Radiographs (including stressed views)
Which factors determine how carpal hyperextension is managed?
- Degree of lameness: if its not lame then you don’t need to do anything
- Dysfunction
- Exercise tolerance
- Load baring of the carpus
